Which of the following metabolic effects may be observed in patients with sepsis?

a. Increased gluconeogenesis

b. Accelerated proteolysis

c. Increased lipolysis

d. Impaired gut metabolism of glutamine

A number of metabolic responses to sepsis have been defined. Glucose production is increased in infected patients which appears to be additive to the augmented gluconeogenesis that occurs following injury. Accelerated proteolysis, increased nitrogen excretion and prolonged negative nitrogen balance also occur following infection with a response pattern similar to  Basic surgical background (Biochemistry, Fluids, Electrolytes, Hemostasis, Shock, Surgical Infections, Wound Healing …etc) Asir Surgery MCQs Bank. © 1422H-2002- first impression © This project was raised after an idia by Dr. Gharama Al-Shehri (consultant surgeon). 17 Developed and typed by Dr. Ghazi Al-Shumrani (intern). that described with injury. Severe infection is often associated with a hypercatabolic state that initiates marked changes in interorgan glutamine metabolism. This process results in accelerated muscle proteolysis and net skeletal muscle glutamine release. The bulk of glutamine is taken up by the liver at the expense of the gut. It appears that sepsis can impair gut metabolism of glutamine. Fat is a major fuel oxidized in infected patients, and increased metabolism of lipids from peripheral fat stores is especially prominent during a period of inadequate nutritional support.